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Lisfranc fracture dislocation

Linda Posted Sun 27th of May, 2012 15:25:17 PM

I know that a Lisfranc fracture is a fracture of the tarsometatarsal joint(s). If the MRI states there is no actual fracture of the bones but rather a dislocation of the tarsometatarsal joints then that would actually be Dx 838.03.
Can one actually fracture a joint versus dislocation.

The doc stabilized under traction and local pressure, the Lisfranc fracture dislocation joints 1,2,3,4 and 5.

Then introduced percutaneously K-wires to from the base of the 2nd, 3rd and 4th metatarsals into the middle tarsals.

Therfore I am considering billing the 28606 x 3. Does code 28606 include the closed reduction. He reduced all five tarsometatarsal joints but pinned only three. What are your thoughts on coding this surgery?

SuperCoder Answered Mon 28th of May, 2012 08:48:23 AM

Fracture means breaking a bone and dislocation means displacement of an organ from its' original location. Lisfranc fracture is a fracture of the foot in which one or all of the metatarsals are displaced from the tarsus (means dislocation). Closed reduction is included in CPT 28606. As physician stabilize under traction and local pressure in the joints 1, 2, 3, 4, and 5 and reduced, but pinned is only in three, still you should code 28606 only once. As percu skeletal fixation itself defines fracture is neither open nor closed, but fracture site is closed by application of pins, wires, or screws as needed. This code does not restrict application of single pin or screw, rather it’s pins or screws.

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